Trends in old-age mortality in seven European countries, 1950-1999

Objective: Different from the general observed decline in old-age mortality, for The Netherlands and Norway there have been reports of stagnation in the decline since the 1980s. We detect periods of stagnation in recent old-age mortality trends, and explore for which causes of death the recent stagnation is most apparent. Study Design and Setting: We applied Poisson regression analysis to total and cause-specific mortality data by age (80+), period (1950-1999), and sex for seven European low-mortality countries. Results: We found large heterogeneity in the pace of decline in the countries under investigation, with periods of stagnation being widespread. In the 1980s and 1990s, stagnation was observed in Denmark, The Netherlands, and Norway (males). Continued mortality decline was observed especially in France. Although smoking has had a marked influence on the trends in old-age mortality, the role of smoking in the recent stagnation seems only modest and restricted to Norway. Mortality from cardiovascular diseases showed important crossnational variations in the pace of decline. Mortality from diseases specifically related to old age increased recently in all countries, except France. Conclusion: Old-age mortality seems highly plastic and susceptible to many factors, with both favorable and unfavorable effects on trends over time. (C) 2004 Elsevier Inc. All rights reserved.